Efficacy of modified Banxia Xiexin decoction in the management of Wei-Pi syndrome (postprandial distress syndrome): study protocol for a randomized, waitlist-controlled trial

Banxia Xiexin decoction: A review on phytochemical, pharmacological, clinical and pharmacokinetic investigations

Banxia Xiexin decoction (BXD), a famous traditional Chinese prescription constituted by Pinelliae Rhizoma, Zingiberis Rhizoma, Scutellariae Radix, Coptidis Rhizoma, Ginseng Radix et Rhizoma, Jujubae Fructus and Glycyrrhizae Radix et Rhizoma Praeparata Cum Mell, has notable characteristics of acrid-opening, bitter down-bearing and sweet-tonification, interfering with tumors, gastrointestinal diseases, central nervous system diseases and much more. Based on the wide clinical applications, current investigations of BXD focused on several aspects: chemical analysis to explore the underlying substrates responsible for the therapeutic effects; basic studies on pharmacological actions of the whole prescription or of those representative ingredients to demonstrate the intriguing molecular targets for specific pathological processes; pharmacokinetic feature studies of single or all components of BXD to reveal the chemical basis and synergistic actions contributing to the pharmacological and clinically therapeutic effects. In this review, we summarized the main achievements of phytochemical, pharmacological, clinical and pharmacokinetic profiles of BXD and its herbal or pharmacologically active chemicals, as well as discussions of our understanding which further reveals the significance of BXD clinically.

Zhizhu Kuanzhong Capsule in treating patients with functional dyspepsia postprandial distress syndrome: study protocol for a multicenter, randomized, double-blind, placebo-controlled, parallel-group clinical trial

Background

Functional dyspepsia (FD) is one of the most common functional gastrointestinal disorders. Based on the various symptoms present in patients with functional dyspepsia postprandial distress syndrome (FD-PDS), routine agents such as acid suppressants, prokinetic drugs, and centrally acting drugs, offer limited treatment choices with potential side effects. As a preliminary clinical trial showed that the marketed product Zhizhu Kuanzhong Capsule (ZZKZ) can improve symptoms in FD-PDS patients, our study aims to provide further evidence on the clinical efficacy and safety of ZZKZ in the treatment of patients with FD-PDS.

Methods

In this multicenter, randomized, patient- and investigator-blinded, placebo-controlled, parallel-group clinical trial, we will recruit patients with FD-PDS from 18 hospitals in China and Australia. The trial will enroll patients with FD-PDS based on the Rome IV diagnostic criteria. A total of 480 eligible patients will be randomized 1:1 into either ZZKZ or placebo group with 8 weeks of treatment and 4 weeks of follow-up. The primary endpoint will be measured by a self-rated Visual Analogue Score (VAS) for the degree of discomfort with both symptoms of postprandial fullness and early satiation, recorded once a day and 7 days a week. The primary analysis will aim to compare the response rate for FD-PDS VAS score between the groups before and after 8 weeks of treatment with an alpha level of 0.05 (2-sided).

Discussion

This trial aims to strengthen the evidence for the efficacy and safety of ZZKZ, a marketed product, in treating FD-PDS. Compared to the previous clinical trial that targeted FD-PDS, this trial will have an 8-week double-blind treatment period to investigate the effect of long-term mediation through comparison with the placebo group.

Trial registration

ClinicalTrials.gov NCT03825692. Registered on 28 January 2019

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06396-5.

Clinical efficacy of Tiaoqi Jiangni decoction in the treatment of functional dyspepsia and its influence on life quality

OBJECTIVE

To observe clinical effects of Tiaoqi Jiangni Decoction combined with mosapride citrate tablets in the treatment of functional dyspepsia and its impact on quality of life.

METHODS

Seventy-six patients with functional dyspepsia were admitted to Cangzhou Central Hospital of Hebei Province from September 2019 to June 2020. They were selected and randomized into a treatment group and a control group (38 cases in each group). Both groups received mosapride citrate tablets (5 mg/time, 3 times/d). The treatment group was additionally given Tiaoqi Jiangni Decoction.

RESULTS

The total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, the sub-scores of each symptom and the overall score of traditional Chinese medicine (TCM) syndrome in the treatment group were significantly lower than those in the control group (all P < 0.05). The overall and sub-item scores of the Functional Digestive Disorders Quality of Life Questionnaire (FDDQL) of both groups saw an increase after treatment (all P < 0.05). There was no significant disparity in sleep and stress between the two groups. The treatment group presented a better performance in other aspects than the control group (all P < 0.05). Before treatment, the two groups showed no significant disparity in the gastric emptying rate of barium bar and mental and psychological state. The two indexes were observed with a rise after treatment, with superior results in the treatment group to those in the control group (P < 0.05). No adverse reactions were observed in the two groups. One month after treatment, the treatment group obtained a lower recurrence rate as compared to the control group (P < 0.05).

CONCLUSION

Tiaoqi Jiangni Decoction in combination with mosapride citrate tablets in the treatment of FD yields a significant clinical effect by substantially alleviating patients' clinical symptoms and improving their quality of life, with no adverse reactions, high safety, and low recurrence rate, which merits further clinical application.

CLINICAL TRIAL REGISTRATION

The name of the registry: Chinese Registry of Clinical Trials.

TRIAL REGISTRATION NUMBER

ChiCTR2100063542. Trial URL: http://www.chictr.org.cn/showproj.aspx?proj=6354283.